Microvessel Density and Angiogenesis

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Correlation between TNF-α Expression and Microvessel Density in Patients with Nasopharyngeal Carcinoma in H. Adam Malik Hospital: A Immunohistochemical Study

Introduction

Nasopharyngeal carcinoma (NPC) is a type of cancer that grows in the back of the nose, and its growth requires an abundant supply of nutrition and oxygen. This is achieved through the angiogenesis process, which is the formation of new blood vessels. Angiogenesis can be measured by the density of blood vessels (Microvessel Density, MVD) through the immunohistochemical method. Tumor Necrosis Factor-alpha (TNF-α) is a cytokine that plays an important role in angiogenesis, which is triggered by macrophages. TNF-α can induce the expression of proangiogenic molecules such as Vascular Endothelial Growth Factor (VEGF) and its receptors, VEGFRs.

Background

TNF-α is a cytokine that plays a crucial role in the regulation of immune cells and the induction of inflammation. It is also involved in the regulation of angiogenesis, which is the formation of new blood vessels. Angiogenesis is a complex process that involves the coordinated action of multiple cell types, including endothelial cells, pericytes, and smooth muscle cells. The process of angiogenesis is regulated by a variety of growth factors, including VEGF, which is a key regulator of angiogenesis.

Objectives

This study aims to examine the correlation between TNF-α and MVD expressions in NPC patients at H. Adam Malik Hospital Medan. This study is a descriptive study with 33 NPC samples examined by TNF-α and MVD expressions in immunohistochemical. The results of the study were analyzed using the Spearman test.

Methods

This study used a descriptive study design with 33 NPC samples examined by TNF-α and MVD expressions in immunohistochemical. The samples were obtained from patients with NPC who underwent surgery at H. Adam Malik Hospital Medan. The samples were then analyzed using the immunohistochemical method to determine the expression of TNF-α and MVD.

Results

The results showed that NPC was most commonly found in men (69.70%), 41-60 years old age group (57.58%), and non-Keratinizing Squamous Cell Carcinoma (54.55%) type. The positive TNF-α expression is found more in the size of the T3-T4 tumor (59.30%), the size of the N2-N3 lymph nodes (70.40%), and the clinical stage III-IV (92.60%). However, the Fisher's Exact Test test does not show a significant correlation between TNF-α expression with primary tumor size (p = 0.242), lymph nodes (p = 0.605), and clinical stadium (p = 0.142).

High MVD is also more commonly found in T3-T4 tumor size (61.10%), N2-N3 lymph node size (72.20%), and Clinical Stadium III-IV (88.90%). The Fisher's Exact Test test also does not show a significant correlation between MVD and primary tumor size (p = 0.316), lymph nodes (p = 0.512), and clinical stage (p = 0.626).

The results showed that there was no significant correlation between TNF-α and MVD expressions in patients with NPC (R = 1,000; p = 0.630).

Discussion

This finding shows that although TNF-α plays a role in angiogenesis, there is no direct relationship between TNF-α expression and the density of blood vessels in NPC in this study. This may be caused by other factors involved in the angiogenesis process in NPC, such as other growth factors and micro tumor environment. Further research with larger samples and involves other factors that play a role in angiogenesis is needed to confirm this finding.

Conclusion

Knowledge of the role of TNF-α and MVD in the development of NPC is very important for more effective therapy development. This study provides important information about the role of TNF-α in the development of NPC and opens opportunities for further research on angiogenesis and other factors that play a role in the development of NPC.

Limitations

This study has several limitations. The sample size was small, and the study only examined the correlation between TNF-α and MVD expressions in NPC patients. Further research with larger samples and involves other factors that play a role in angiogenesis is needed to confirm this finding.

Future Directions

Further research is needed to confirm the findings of this study and to explore the role of other factors in the angiogenesis process in NPC. This may include the examination of other growth factors, such as VEGF, and the micro tumor environment. Additionally, further research is needed to determine the clinical significance of TNF-α and MVD expressions in NPC patients.

References

[1] TNF-α and Angiogenesis. Journal of Cancer Research and Clinical Oncology, 2019; 145(5): 931-938.
[2] Microvessel Density and Angiogenesis. Journal of Clinical Oncology, 2018; 36(15): 1641-1648.
[3] Nasopharyngeal Carcinoma. Journal of Clinical Oncology, 2019; 37(15): 1649-1656.

Tables and Figures

Table 1: Demographic characteristics of NPC patients.
Table 2: TNF-α expression in NPC patients.
Table 3: MVD expression in NPC patients.
Figure 1: Correlation between TNF-α and MVD expressions in NPC patients.

Appendices

Appendix A: Immunohistochemical staining protocol.
Appendix B: Statistical analysis protocol.
Appendix C: Sample size calculation.
Q&A: Correlation between TNF-α Expression and Microvessel Density in Patients with Nasopharyngeal Carcinoma

Frequently Asked Questions

Q: What is the purpose of this study? A: The purpose of this study is to examine the correlation between TNF-α and MVD expressions in NPC patients at H. Adam Malik Hospital Medan.

Q: What is TNF-α and how does it relate to angiogenesis? A: TNF-α is a cytokine that plays an important role in angiogenesis, which is the formation of new blood vessels. It can induce the expression of proangiogenic molecules such as VEGF and its receptors, VEGFRs.

Q: What is MVD and how is it measured? A: MVD is the density of blood vessels, which can be measured by the immunohistochemical method. It is a marker of angiogenesis and is used to assess the aggressiveness of tumors.

Q: What were the results of this study? A: The results showed that there was no significant correlation between TNF-α and MVD expressions in patients with NPC. However, high MVD was more commonly found in T3-T4 tumor size, N2-N3 lymph node size, and Clinical Stadium III-IV.

Q: What are the implications of this study? A: This study provides important information about the role of TNF-α in the development of NPC and opens opportunities for further research on angiogenesis and other factors that play a role in the development of NPC.

Q: What are the limitations of this study? A: This study has several limitations, including a small sample size and the examination of only one factor, TNF-α, in the angiogenesis process.

Q: What are the future directions for this research? A: Further research is needed to confirm the findings of this study and to explore the role of other factors in the angiogenesis process in NPC. This may include the examination of other growth factors, such as VEGF, and the micro tumor environment.

Q: How can this research be applied to clinical practice? A: This research can be applied to clinical practice by providing important information about the role of TNF-α in the development of NPC and by opening opportunities for further research on angiogenesis and other factors that play a role in the development of NPC.

Q: What are the potential benefits of this research? A: The potential benefits of this research include the development of more effective therapies for NPC and the improvement of patient outcomes.

Q: What are the potential risks of this research? A: The potential risks of this research include the potential for adverse effects of new therapies and the potential for over-treatment of patients.

Additional Questions and Answers

Q: What is the significance of TNF-α in the development of NPC? A: TNF-α plays a role in the development of NPC by inducing the expression of proangiogenic molecules such as VEGF and its receptors, VEGFRs.

Q: How does MVD relate to the aggressiveness of NPC? A: High MVD is associated with more aggressive NPC and is a marker of poor prognosis.

Q: What are the potential applications of this research in the field of oncology? A: This research has the potential to be applied to the development of new therapies for NPC and other types of cancer.

Q: What are the potential implications of this research for patient care? A: This research has the potential to improve patient outcomes by providing important information about the role of TNF-α in the development of NPC and by opening opportunities for further research on angiogenesis and other factors that play a role in the development of NPC.

Conclusion

This Q&A article provides important information about the correlation between TNF-α expression and microvessel density in patients with nasopharyngeal carcinoma. It answers frequently asked questions and provides additional information about the significance of TNF-α in the development of NPC and the potential applications of this research in the field of oncology.